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Arkansas has passed new legislation banning gender-affirming care for trans youth. Experts say it could do a great deal of harm to their mental and physical well-being. Julie Bennett/Getty Images

Last week, Arkansas became the first state to ban gender-affirming care for transgender youth, defying a prior veto from Gov. Asa Hutchinson.

Called the “Save Adolescents From Experimentation (SAFE) Act,” the legislation prohibits physicians from providing hormone therapy and puberty blockers to young people.

And what is particularly cruel, say critics, is the legislation applies even to people who have already begun these treatments.

The legislation made national headlines and sent shockwaves to trans youth and their families across the country.

“This is devastating to transgender youth and their families,” said Jamie Bruesehoff, a New Jersey parent of a trans daughter, Rebekah. “This will cost lives. My child’s healthcare should be between me as a parent, her, and her team of medical providers.”

“I’m so scared for the youth in Arkansas,” Rebekah said. “I’m scared to say what would happen if I didn’t have access to the affirming healthcare I receive, if I wasn’t on medicine to block puberty. I don’t think I’d be alive.”

“It’s exhausting to know that my rights are constantly up for debate,” she added. “I just want to be a kid. I wish I could be worrying about my homework instead of what state is trying to take away my rights, my healthcare, and practically erase me from society.”

The vast majority of health experts support gender-affirming care.

Major medical organizations like the American Academy of Pediatrics (AAP), which comprises nearly 70,000 members, and the American Psychiatric Association have spoken out against the ban.

Dr. Gary Wheeler, president of AAP’s Arkansas chapter board of directors and a pediatric infectious disease physician, is “extremely disappointed” in the state’s decision to overturn the governor’s veto.

However, he said he’s not surprised.

Wheeler, who testified before legislative committees against the law, said lawmakers in the Republican-majority legislature were not overly receptive to the testimonies from experts in support of gender-affirming care.

The reason? He pointed to the “extensive work” done in advance by outside interest groups to lobby Arkansas politicians and polarize the issue as part of national culture wars.

The Human Rights Campaign (HRC), a major LGBTQIA+ political group, pointed to the Heritage Foundation, the Alliance Defending Freedom (which is designated by the Southern Poverty Law Center as a hate group), and the Eagle Forum (founded by the late anti-gay activist Phyllis Schlafly) as among the primary drivers of this legislation — not families with transgender kids, of which there are comparatively few in Arkansas.

“I want anti-transgender lawmakers to talk to transgender youth and their families before trying to legislate their lives,” Jamie Bruesehoff said. “We’re real families with real lives. I wish they’d get to know us before speaking and voting on things they know nothing about.”

While there were a few medical professionals who did testify in support of the Arkansas ban, they represented “fringe” groups, like the American College of Pediatricians (ACPeds), which comprises many religious-leaning physicians who parted ways with the AAP over cultural issues.

Wheeler said it was “disturbing” to watch members of his profession and uninformed politicians “cherry pick” information in legislative committees, misread journal papers, and use outdated data while “overlooking what is clearly detrimental to these children, which is the systematic legislative bullying of a class of individuals that causes harm to them.”

For example, the ban’s primary sponsor, Republican Rep. Robin Lundstrum, cited a 2011 study saying that, after gender confirmation surgery, transgender people were more likely to consider suicide and have mental health issues.

But that same study also said surgery helped alleviate gender dysphoria.

First, the legislation denies the medical care itself to transgender young people under age 18.

Many people have already begun hormone therapy only to have it disrupted at critical periods in development after extensive research and decision making efforts from their family members.

There’s also the serious harm to mental health that comes when elected officials are debating your dignity.

A pediatric endocrinologist working with the AAP saw a “dramatic uptake” in calls from parents concerned with their trans children’s mental well-being, attested Wheeler.

Indeed, resources like the Trans Lifeline (877-565-8860), which provides support to trans young people contemplating suicide, have routinely seen calls increase during past political attacks on the transgender community.

An example is when North Carolina passed a “bathroom bill” denying public restroom use to trans people in 2016.

“I’m very concerned that those who are proponents of the bill are ignoring the harm that they’re causing just by bringing this legislation forth,” Wheeler said.

So, why would legislators vote to harm children?

Wheeler believes that conservative interest groups are “very effective” at lobbying individual legislators with no background in transgender health.

Additionally, he has observed a growing distrust of the medical community in Arkansas politics, which has become increasingly polarized.

“I think the credibility of physicians has really eroded. I think in the past, we were thought to be dispassionate, nonpartisan technocrats, but we’re not seen that way anymore,” he said.

“I think there’s some political slant to almost every issue that is presented now in our legislature, unfortunately. And as a result of that, the best decisions are not always being made,” he said.

And Arkansas is not alone in pushing anti-transgender legislation.

The HRC counted 82 anti-trans bills introduced in state legislatures — a record high for any year — and that was only by March 13.

Around 30 states are now considering legislation similar to Arkansas’s. In addition to assailing gender-affirming care, these bills target the participation of transgender athletes in sports.

“These bills are not addressing any real problem, and they’re not being requested by constituents,” said Alphonso David, HRC’s president, in a statement. “Rather, this effort is being driven by national far-right organizations attempting to score political points by sowing fear and hate.”

These groups are doing so against the tide of popular opinion.

According to a poll conducted last fall by the HRC and Hart Research Group, at least 87 percent of respondents in 10 swing states think trans people should have equal access to medical care.

States that advance anti-transgender laws have a lot to lose — economically and reputationally.

In March, more than 65 major U.S. companies like Apple, Facebook, American Airlines, and Hilton signed a statement opposing anti-LGBTQIA+ legislation and outlined the negative impact these laws would have on employees and the economy.

For example, The Associated Press estimated North Carolina’s “bathroom bill” may have resulted in $3.76 billion in lost business over the course of 12 years.

Most troublingly, the extent of the legislation’s harm to trans kids is still unknown.

A large concern for Wheeler is that, under the enacted law, referrals of transgender kids undergoing gender transition management to mental healthcare may be forbidden.

This will leave them “horribly affected,” he said bluntly.

And under the ban, healthcare professionals seeking to help trans youth risk losing their medical license.

Another concern is that trans kids and their parents who want to seek treatment will have to travel outside of the state, which, much like abortion access in some states, would be an option available only to the wealthy or people living in border towns “that can literally cross the river and get care.”

Additionally, Wheeler is unsure telemedicine appointments with physicians in other states will be permitted.

Before the anti-trans bill’s approval, the AAP’s Arkansas chapter had attempted to hold meetings with legislators to educate them on the issue and to assuage them that the group’s work was nonpartisan — but that in-person work was interrupted by the pandemic.

“We’ve got a lot of work to do” going forward, Wheeler said.

Fortunately, trans young people are “tough as nails,” said Wheeler, who witnessed their bravery in testifying for their rights before legislative committees.

And he has a message for them on behalf of his organization.

“Be patient with the people that control the power around you. We’re going to keep working with you to try to get you across the finish line at some point. So, don’t give up. Don’t stop inspiring us, because I think a lot of folks that have worked in this area are very discouraged right now.

“And I think the patients themselves are the ones that are going to keep the fires stoked and continue to inspire us to try to do the work that we need to do to improve the law and improve services and healthcare for these individuals,” Wheeler said.

From a legal statement, the American Civil Liberties Union (ACLU) is also vowing to support trans kids and fight the Arkansas legislation in court.

A ban on gender-affirming care is “not only wrong, it’s also illegal,” said Holly Dickson, ACLU of Arkansas executive director, in a recent statement.

Rebekah is one of those youth leaders who will continue to speak out against those who would seek to demonize her community.

“We’re not scary. We’re not a threat. We are just kids like all other kids, and being transgender is just a tiny part of who we are,” she said.

“We are musicians, athletes, writers, leaders, future politicians, and more.”